Provider Demographics
NPI:1063561215
Name:FINCH, DERRILL C (DDS)
Entity type:Individual
Prefix:
First Name:DERRILL
Middle Name:C
Last Name:FINCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 S ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5923
Mailing Address - Country:US
Mailing Address - Phone:814-238-4090
Mailing Address - Fax:814-234-8540
Practice Address - Street 1:1315 S ALLEN ST
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5923
Practice Address - Country:US
Practice Address - Phone:814-238-4090
Practice Address - Fax:814-234-8540
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022941-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist